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Fetal origins of allergic

disease
By: Kate Biese, Kristin Kirkman, and Tien Vo
Background: defining the problem
Allergic disease: condition of unfavorable
immune system reaction to foreign substance
that induces high sensitivity
Allergie introduced by Clemens von
Pirquet
Discovered while treating patients who reacted
with new symptoms
50% children have allergies
Background Allergic Reaction
Allergen Y Y
Y
initial exposure to Histamines
Y

allergen released Y
B cell Y
Y

Release of IgE Y Y
Antibody
Y

subsequent
Mast cell w/ IgE
Y

exposure to allergen
Y
Y

Y Y Y
Y

Y
Y
Public health and clinical importance
Barker hypothesis
Lack of exposures during critical period leads inability
to develop antibodies for allergens
Hygiene hypothesis
Hyper-cleanliness leads to unprepared immune system
Thrifty phenotype
Increased maternal exposure to disease prepares fetus for
life outside
Public health and clinical importance
Rush Medical College study shows breastfeeding
reduces infant risk for GI & respiratory infection
Maternal exposure to infection increases immune production
of antibodies transported through breastfeeding
Fetal exposure in utero lowers need for costly
antibiotics, EpiPens, etc.
Decreasing allergic disease
Increase potential for healthy habits (ie. exercise, diet,
etc.)
Increase immunity for posterity
Risk Factors: Maternal Nutrition
Maternal food consumption during pregnancy and asthma, respiratory and atopic
symptoms in 5-year-old children, Willers et al. 2007

Maternal apple consumption protective for asthma


Maternal fish consumption protective for eczema

Maternal diet during pregnancy in relation to eczema and allergic


sensitization in the offspring at 2 y of age, Sausenthaler et al. 2007

n6 polyunsaturated fatty acids increase risk of allergic sensitization


n3 polyunsaturated fatty acids decrease risk of allergic sensitization
Risk Factors: Microbial Exposure
Study on Exposure to Farming

Regulatory T cells
increased
FOXP3 levels increased
Postnatal exposures:breastfeeding
Postnatal Exposure: Hygiene Theory
Food Allergy

Eczema
Asthma
Future research
Recommendations for future research:

Long term effects: Short term effects have been studied,


but further research should be done exploring
consequences later in life
Multiple allergic diseases
Maternal diet: Hygiene hypothesis for food
More future research
Toxic chemicals:

Critical window

Sensitive window

Epigenetics and epigenetic modification:


How does reversibility play a part?
conclusion
Preventing allergic disease leads
to longer lives
Crucial, time-sensitive
Information = success!
Identification and prevention of
risk factors